PROJECT SUMMARY A recent addition to trauma center certification by the American College of Surgeons is the requirement for level 1 trauma centers to have the capacity to identify risky alcohol use and provide interventions to trauma patients. There has been a lack of consistent integration of evidence-based practices around this component of acute care. SBIRT is an evidence-based model to screen for risky alcohol use and provide a brief intervention to those screening positive. The aims of the present application are: 1) to improve knowledge, self-efficacy and readiness to integrate SBIRT into participating pediatric level 1 trauma centers;2) to examine the development of a trauma center policy and protocol for adoption of adolescent SBIRT within participating pediatric level 1 trauma centers;3) to examine the implementation of a trauma center policy and protocol for adolescent SBIRT within participating pediatric level 1 trauma centers;4) to examine maintenance of SBIRT services within participating pediatric level 1 trauma centers and 5) to develop recommendations on implementing SBIRT within a pediatric level 1 trauma center. This translational research study will incorporate the following approaches: examination of successful models and methods for dissemination, implementation, and evaluation of a guideline for care of the acutely injured, development of strategies for effective dissemination, and identification of barriers to effective translation and subsequent use of information and development of effective solutions to address these barriers. The research team will provide technical assistance to 7 pediatric trauma centers and measure adaptation, adoption, implementation, fidelity and maintenance of SBIRT for their injured adolescent population. SBIRT implementation technical assistance (online, in person workshops and monthly conference calls) will incorporate established resources for health care providers and will be delivered over 22 months. The research team will also monitor and collect data on adoption, implementation and maintenance over 30 months. Change in adoption, implementation and maintenance among sites will be measured by trauma center leaders'self report and retrospective blinded medical chart review. PUBLIC HEALTH RELEVANCE: RELEVANCE The goal of the proposed translational research study is to increase the use of SBIRT among injured adolescents treated at pediatric level 1 trauma centers. This study will allow researchers to better understand best practices for the dissemination and adoption of alcohol screening and brief intervention within pediatric trauma centers.